Health Insurance, Beneficiary & Additional Forms

For New Participating Agency (PA) Employees

Below are important forms and steps to follow to complete your onboarding.

  1. Within two weeks of your hire date, complete the mandatory forms below:


    Success tips: Open the links in Google Chrome or Microsoft Edge for the best user experience.  Also, each Beneficiary Form’s cover letter contains important explanatory information. Read it carefully before naming your beneficiaries.

  2. Explore your health, life, and flexible spending account options.

    Review the resources below to learn more about your options:

  3. Elect your health insurance options.

    Within 60 days of your hire date:
    Select your health insurance plans by using the SeamlessDoc form: 2025 Participating Agency Health and Life Insurance Election Form.  If you want to enroll in a Flexible Spending Account for 2026, please also complete the 2026 Participating Agency Health and Life Insurance Election Form at the same time you make your new hire elections.
     

Important Deadlines and Effective Dates

  • There is a 60-day window from your date of hire to make your health insurance elections (31 days if electing between 1-4 x salary Optional Life). If you miss the 60-day deadline, then you must wait until the next annual Open Enrollment to enroll for the next plan year.
  • Benefits do not become effective until the date you complete your transaction/form and supply any Required Documentation & Qualifying Life Events (PDF) within the 60-day window.
  • All Open Enrollment changes submitted during Open Enrollment (October 6 – 24, 2025) will become effective January 1, 2026.

For More Information

If You Need Health Insurance Assistance